Document Detail

Serial greyscale and radiofrequency intravascular ultrasound assessment of plaque modification and vessel geometry at proximal and distal edges of bare metal and first-generation drug-eluting stents.
MedLine Citation:
PMID:  22717925     Owner:  NLM     Status:  In-Data-Review    
Background: Little is known about the correlation between modifications in plaque composition at stent edges and the changes in vessel geometry. This study sought to evaluate, by serial greyscale intravascular ultrasound (IVUS) and Virtual Histology® intravascular ultrasound (VH®-IVUS), the modifications in plaque composition at the edges of drug-eluting and bare metal stents and the correlation of these findings with changes in the measurements of vessel, lumen and plaque area at those segments. Methods and results: Single-centre, prospective and randomised (1:1) evaluation of 40 patients with acute coronary syndrome treated with bare metal (Driver™; Medtronic, Santa Clara, CA, USA; n=20 patients) or drug-eluting stents (Cypher™; Cordis, Miami Lakes, FL, USA; n=20 patients). IVUS and VH-IVUS assessments were done post-procedure and at nine months. Primary endpoint included the modification in vessel, lumen and plaque area and in the composition of the plaque in the mean time between the baseline and follow-up procedure. At the proximal edge of the vessel treated with the Cypher™ stent, a trend toward positive vessel remodelling (D=+0.6 mm2, p=0.06) was observed while at the distal edge, less plaque growth (D=+0.2 mm2 vs. D=+1.1 mm2, p<0.001), resulted in a larger lumen area at follow-up. By VH, there was a marked reduction in the percentage of fibrotic tissue and necrotic core at the edges of both stents and a positive correlation was seen between increase in percentage of fibro-fatty component and increase in plaque area (r=0.78, p=0.01). Conclusion: Patients treated with drug-eluting stents (DES) experienced less plaque growth, especially at the distal edge of the stents. Modifications in plaque composition, with increase in fibrofatty tissue component, may partially explain these findings.
J Ribamar Costa; Alexandre Abizaid; Amanda Sousa; Dimytri Siqueira; Daniel Chamié; Fausto Feres; Ricardo Costa; Rodolfo Staico; Galo Maldonado; Marinela Centemero; Luiz Fernando Tanajura; Renata Viana; Aurea Chaves; Andrea Abizaid; J Eduardo Sousa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  8     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  225-34     Citation Subset:  IM    
Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
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